The Consent For Surgery Form is a critical legal and medical document required by Indonesian healthcare law before any surgical procedure can be performed. It serves as documented evidence that the patient has been fully informed about and has agreed to the proposed surgery, fulfilling requirements under Law No. 29 of 2004 on Medical Practice and related regulations. The form must be completed prior to any non-emergency surgical procedure and includes detailed information about the surgery, its risks and benefits, alternatives, and post-operative care. It protects both healthcare providers and patients by ensuring transparent communication and documented consent, while meeting all regulatory requirements for medical procedures in Indonesia. The document is particularly important in risk management and medical-legal documentation, requiring careful attention to detail in its completion and storage.
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
Your data doesn't train Genie's AI
You keep IP ownership of your docs
1. Patient Information: Complete details of the patient including full name, date of birth, ID number (KTP/passport), address, and contact information
2. Healthcare Provider Information: Details of the hospital/medical facility, primary surgeon, and other key medical professionals involved in the procedure
3. Procedure Details: Specific description of the surgical procedure, including the medical term and layman's explanation of what will be done
4. Risks and Benefits: Detailed explanation of the potential risks, complications, and expected benefits of the surgery
5. Alternative Treatments: Description of alternative treatment options available and consequences of not proceeding with the surgery
6. Anesthesia Consent: Specific information about the type of anesthesia to be used and its associated risks
7. Declaration and Signatures: Patient (or legal representative) declaration of understanding and consent, with spaces for signatures, dates, and witness details
1. Interpreter Declaration: Required when the patient needs language interpretation services, including interpreter's details and confirmation of accurate translation
2. Legal Representative Authorization: Required when the patient is a minor, unconscious, or legally incompetent, including details of the legal representative's authority
3. Blood Transfusion Specific Consent: Required when there is a possibility of blood transfusion during the procedure, including specific risks and alternatives
4. Photography Consent: Optional section for consent to photograph or video record the procedure for medical documentation or educational purposes
5. Religious or Cultural Considerations: Required when specific religious or cultural factors need to be acknowledged and accommodated during the procedure
1. Procedure Information Sheet: Detailed medical information about the specific procedure, including diagrams or illustrations where appropriate
2. Pre-operative Instructions: Detailed instructions for the patient to follow before the surgery, including fasting requirements and medication adjustments
3. Post-operative Care Guide: Information about recovery, follow-up care, and warning signs to watch for after the procedure
4. Hospital Facility Declaration: Statement of the hospital's accreditation and emergency facilities available during the procedure
Find the exact document you need
Informed Consent And Health Declaration Form
An Indonesian-law compliant combined informed consent and health declaration document for medical procedures and treatments, meeting national healthcare regulatory requirements.
Download
Informed Consent Form
Indonesian-compliant Informed Consent Form for medical procedures or research participation, meeting local healthcare regulations and patient rights requirements.
Download
Beauty Consent Form
An Indonesian-law compliant consent form for beauty treatments and procedures, ensuring informed client consent and legal protection for service providers.
Download
Aesthetic Consent Form
An Indonesian-compliant informed consent form for aesthetic procedures, meeting local healthcare regulations and protecting both provider and patient interests.
Download
Iv Consent Form
An Indonesian-compliant informed consent form for IV procedures, meeting local healthcare regulations and ensuring documented patient consent.
Download
Consent Document
An Indonesian law-compliant consent document for personal data collection and processing under the PDP Law.
Download
Patient Consent Form For Treatment
An Indonesian-compliant medical consent form documenting patient authorization for treatment, aligned with local healthcare regulations.
Download
Travel Permission Letter For Minor
An Indonesian legal document authorizing minor travel, compliant with national child protection and immigration laws.
Download
Consent Permission Letter
An Indonesian law-compliant formal letter documenting explicit authorization from one party to another, establishing legal consent for specific actions or purposes.
Download
Certificate Of Consent Form
An Indonesian law-compliant document that formally records and validates explicit consent for specific activities or procedures.
Download
Permission Letter From Parents
An Indonesian law-compliant document where parents/guardians authorize specific activities or services for their minor child.
Download
Employee Media Release Form
An Indonesian law-compliant consent form authorizing employer use of employee media content, including images and recordings, for company purposes.
Download
Photo Authorization Form
An Indonesian law-compliant authorization form for photographic usage rights, ensuring proper consent and data protection under local regulations.
Download
Waxing Consent Form
An Indonesian-compliant consent form for waxing services that documents client approval and understanding of the procedure, risks, and aftercare requirements.
Download
Sports Consent Form
An Indonesian-compliant consent form for sports participation that covers risk acknowledgment, medical declarations, and liability releases under Indonesian sports law.
Download
Reference Consent Form
An Indonesian-law compliant consent form authorizing the release of employment references, aligned with local PDP and employment regulations.
Download
Participant Consent Form
An Indonesian-compliant legal document for obtaining informed consent from research participants, adhering to local data protection and research regulations.
Download
Nail Consent Form
An Indonesian-compliant consent form for nail treatments, documenting client approval and treatment details while meeting local health and safety regulations.
Download
Data Privacy Consent Form
An Indonesian law-compliant Data Privacy Consent Form for obtaining explicit consent for personal data processing under UU PDP requirements.
Download
Consent Declaration Form
An Indonesian law-compliant consent declaration form for personal data collection and processing under the PDP Law.
Download
Video Consent And Release Form
An Indonesian law-compliant consent form for video recording and usage rights, protecting both content creators and participants under local data protection regulations.
Download
Statement Of Consent
An Indonesian law-compliant document recording explicit permission for specific actions or data processing, governed by the Civil Code and Personal Data Protection Law.
Download
Social Media Consent Form
An Indonesian law-compliant consent form for social media content usage and personal data processing, aligned with PDP Law requirements.
Download
Personal Information Consent Form
An Indonesian law-compliant consent form for personal data collection and processing under the PDP Law, ensuring legal data handling and subject rights protection.
Download
Permission To Treat Form
An Indonesian-compliant medical consent form documenting patient authorization for healthcare treatment, aligned with local health regulations and patient rights requirements.
Download
Parental Consent Letter
An Indonesian law-compliant document allowing parents/guardians to authorize specific permissions regarding their minor child.
Download
Parent Consent Form For Work
An Indonesian legal document providing parental/guardian authorization for minor employment, ensuring compliance with national labor laws and child protection regulations.
Download
Mutual Consent Agreement
An Indonesian law-governed agreement documenting mutual understanding and consent between parties, establishing agreed terms and conditions.
Download
Media Permission Form
An Indonesian-compliant legal document granting permission for media content usage, subject to Indonesian copyright and data protection laws.
Download
Letter Of Consent Form
An Indonesian-law governed document that formally captures explicit permission or authorization from an individual or entity for specific actions or uses, ensuring compliance with local consent and data protection regulations.
Download
Generic Consent Form
An Indonesian law-compliant consent form template for documenting explicit permission from individuals, adhering to PDP Law requirements.
Download
Employee Consent Letter
An Indonesian-law governed document obtaining explicit employee consent for specific workplace actions or data usage, complying with local labor and data protection laws.
Download
Consent And Indemnity Form
An Indonesian law-governed document combining explicit consent provisions with indemnification terms to manage risk and liability between parties.
Download
Massage Consent Form
An Indonesian-compliant consent form for massage services that documents client approval, health information, and data privacy agreements under local healthcare regulations.
Download
Consent Letter For Rent Agreement
An Indonesian law-compliant formal letter providing authorized consent for rental arrangements, incorporating local property regulations and civil code requirements.
Download
Consent For Surgery Form
An Indonesian-compliant surgical consent form documenting patient authorization and understanding of proposed surgical procedures, risks, and benefits.
Download
Filming Permission Form
An Indonesian law-governed permission form authorizing filming activities at specific locations, establishing terms and conditions for film production while ensuring regulatory compliance.
Download
Consent For Access To Information Form
An Indonesian law-compliant consent form for authorized access to personal information, aligned with the PDP Law requirements.
Download
Spa Consent Form
An Indonesian-law compliant spa consent form capturing client information, medical history, and treatment authorizations while ensuring regulatory compliance with local spa service requirements.
Download
Photography Consent And Release Form
An Indonesian law-compliant consent and release form for photography services, protecting both photographer and subject rights under local data protection and copyright laws.
Download
Genie’s Security Promise
Genie is the safest place to draft. Here’s how we prioritise your privacy and security.
Your documents are private:
We do not train on your data; Genie’s AI improves independently
All data stored on Genie is private to your organisation
Your documents are protected:
Your documents are protected by ultra-secure 256-bit encryption
We are ISO27001 certified, so your data is secure
Organizational security:
You retain IP ownership of your documents and their information
You have full control over your data and who gets to see it
.png)
.png)